Nearly every day, news headlines are dominated by new ideas from the Trump Administration on how they plan to improve health outcomes, sparking nationwide debate about the best path forward. Central to these efforts is the Make America Healthy Again movement, which raises important questions about how we confront one of the nation’s most pressing public health crises: the alarming rise of chronic disease among children.
At CAI, we share this concern and urgency. We believe that achieving positive health outcomes in children requires community-based, locally led solutions that are tailored to the realities of the neighborhoods and families most at risk.
Our experience has shown that long-lasting health improvements in chronic diseases among children begin with and within the community. For over four decades, CAI has implemented localized, multi-sectoral, evidence-based interventions designed to improve child health outcomes by integrating education, food system reform, behavioral change, and collaboration across local stakeholders.
Take for example, CAI’s National HIV Learning Center, which trains organizations and health departments in rural and urban communities across the country to diagnose, treat, and prevent HIV. The communities that have this support are ultimately better prepared to respond to HIV outbreaks.
To connect kids to healthier foods, we are working with 44 community-based organizations and city agencies in Colorado to deploy food-based education that helps drive down child food insecurity rates. Meanwhile, throughout New York state, CAI has trained health officials to improve wait times and enhance nutrition services delivered by Women, Infants and Children (WIC) agencies. As the MAHA report agrees, this program has driven positive results for infant and child health.
In Mississippi, the use of tobacco and e-cigarette use poses a serious threat to learning, development, and overall health. Through direct, community-based engagement, CAI has led advocacy efforts and trained hundreds of residents in evidence-based smoking prevention strategies and helped shift social norms to counteract targeted marketing in economically disadvantaged areas.
From schools that incorporate nutrition and wellness into their daily curriculum to parents trained in practical home-based strategies for healthy eating and activity, these community-level initiatives are redefining what prevention looks like.
That’s because true transformation requires more than programs—it requires capacity building. This means investing in training, technical assistance, and awareness campaigns that empower local leaders, educators, and families to take ownership of health outcomes.
By strengthening capacity, we lay the foundation for behavioral changes that are both culturally relevant and sustainable. When people see health as part of their everyday lives, interwoven in their communities, lasting change becomes possible.
Capacity development also enables policy development that supports healthier environments for our children. There is no more powerful force than grassroots efforts led by our communities to influence policy that makes it easier for families to make healthy choices.
Finally, by building capacity, we can foster social norms around wellness that transform health from an individual burden into a shared community value.
These principles are not just ideals; they are essential components for any health initiative. Without grounding national efforts into the realities and strengths of local communities, any movement will remain limited and short-lived.
If the Make America Healthy Again movement is to succeed, it must prioritize investment in capacity building and community empowerment as central pillars of its approach. Federal efforts can only go so far without engaging the people who live, work, and raise children in the communities most affected by poor health outcomes.
The call is clear: To achieve the health and nutrition goals of this Administration, we must make our communities the front line of prevention—and invest in the capacity building that will sustain change for generations—for our children, and the adults they will become.
Barbara Cicatelli is the Founder and CEO of CAI Global, a non-profit organization she founded in 1979 to give agencies that serve vulnerable communities the best possible on-the-job education, training, and technical assistance. Today, CAI provides capacity-building services to more than 20,000 professionals every year to help them deliver high-quality health care and social services to millions of people.
